Diffuse Cerebral Hypoxia in the Post Resuscitation Phase: Clinical and Ethical Reflections on a Case
Mehak Bhagat1, Mohammad Aquib2, Moayad Ahmed3*
1Government Medical College, Amritsar, India.
2Dr. N.T.R University of Health Sciences & Kurnool Medical College, India.
3Assistant Professor of Neurosurgery, Ibn Sin University, Khartoum, Sudan. Department of Neurosurgery, Sheikh Tahnoon bin Mohammed Medical city, Al-ain, UAE.
*Corresponding Author: Dr. Moayad Ahmed, MBBS, MD, Assistant Professor of Neurosurgery, Ibn Sin University, Khartoum, Sudan. Department of Neurosurgery, Sheikh Tahnoon bin Mohammed medical city, Al-ain, UAE. ORCID: 0000-0001-9947-3593
https://doi.org/10.58624/SVOANE.2026.07.002
Received: December 17, 2025
Published: January 23, 2026
Citation: Bhagat M, Aquib M, Ahmed M. Diffuse Cerebral Hypoxia in the Post Resuscitation Phase: Clinical and Ethical Reflections on a Case. SVOA Neurology 2026, 7:1, 06-14. doi. 10.58624/SVOANE.2026.07.002
Abstract
Background: Delayed initiation of cardiopulmonary resuscitation (CPR) following cardiac arrest is strongly associated with adverse neurological outcomes, including widespread hypoxic brain damage. Prompt and effective CPR is essential to mitigate irreversible cerebral injury and improve patient prognosis.
Case Presentation: We report the case of a 57-year-old male who sustained physical assault at his workplace and subsequently collapsed due to cardiac arrest. Cardiopulmonary resuscitation was not started immediately, and there was a delay of approximately fifteen minutes before CPR was initiated. On arrival at a tertiary care facility, the patient exhibited no pulse and was unresponsive, necessitating 15 to 20 minutes of intensive resuscitative efforts to achieve return of spontaneous circulation (ROSC). Despite stabilization and mechanical ventilatory support, he remained comatose with a Glasgow Coma Scale (GCS) score of 3. MRI revealed diffuse hypoxic-ischemic encephalopathy involving the hippocampus, bilateral basal ganglia, and frontoparietal cortices. The patient was managed with neurocritical care, rehabilitation, and underwent tracheostomy. While gradual motor improvement was noted, he remained in a semi-comatose state with ongoing cognitive impairment, requiring long-term supportive care.
Conclusion: This case underscores the severe consequences of delayed CPR and highlights the significant physical, emotional, and financial burden on caregivers. It also emphasizes the pivotal role of primary care and family medicine practitioners in promoting community-based CPR education, facilitating caregiver support, and coordinating multidisciplinary rehabilitation services to improve outcomes in similar scenarios.
Keywords: Delayed resuscitation, hypoxic brain injury, CPR, ROSC.
